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Retrograde Ejaculation: Causes, Symptoms, Risk Factors, Diagnosis, Treatment, Prevention and Complications

Nov 06, 2023

Retrograde Ejaculation: Causes, Symptoms, Risk Factors, Diagnosis, Treatment, Prevention and Complications

Retrograde ejaculation is the term for when sperm enters the bladder during an orgasm instead of the penis. Even if you don't ejaculate much, you could still experience a sexual climax. This is known as a dry orgasm.

Retrograde ejaculation can render males sterile, though it doesn't damage them. Retrograde ejaculation therapy is typically only necessary to boost fertility.

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Causes Of Retrograde Ejaculation

During a male orgasm, the vas deferens tube carries sperm to the prostate, where they mix with other fluids to make liquid semen or ejaculate. The bladder neck muscle tightens at the opening of the bladder to prevent ejaculation from entering the bladder as it travels from the prostate into the tube inside the penis (the urethra). This muscle is the one that holds urine in your bladder until you need to urinate.

Semen enters the bladder during retrograde ejaculation instead of exiting the body through the penis.

Retrograde ejaculation results in partial contraction of the bladder neck muscle. Instead of exiting your body through the penis, sperm can now enter the bladder.

A variety of conditions might cause problems with the muscle that closes the bladder during ejaculation. These comprise:

  • Testicular cancer surgery, including dissection of the retroperitoneal lymph nodes, neck surgery of the bladder, and prostate surgery
  • Adverse effects of certain medications for depression, hypertension, and enlarged prostate
  • Diseases that destroy nerves, such as diabetes, multiple sclerosis, Parkinson's disease, or spinal cord injuries

Dry orgasm, on the other hand, which is the ejaculation of little to no semen, can also occur in other circumstances. Among these scenarios are:

  • Prostatectomy: the surgical excision of the prostate (sometimes known as a cystectomy)
  • Radiation treatment for individuals with pelvic cancer

Also Read: Umbilical Hernia: Causes, Symptoms, Risk Factors, Diagnosis, Treatment and Complications

Symptoms Of Retrograde Ejaculation

Retrograde ejaculation does not affect your ability to achieve an erection or have an orgasm; instead, it causes your climax to occur in your bladder instead of your penis. Signs and symptoms of retrograde ejaculation include:

  • Dry orgasms are those in which you ejaculate very little or no sperm from your penis.
  • Murky urine following an orgasm due to the presence of semen
  • Incapacity to conceive a woman (male infertility)

Also Read: Barrett's Esophagus: Causes, Symptoms, Risk Factors, Diagnosis, Treatment and Complications

Risk Factors Of Retrograde Ejaculation

There is an increased risk of retrograde ejaculation if:

  • You have diabetes or multiple sclerosis.
  • You've had surgery on your prostate or bladder.
  • Certain drugs are used to treat high blood pressure or mental disorders.
  • You have injuries to your spinal cord.

Also Read: Arteriovenous Fistula : Causes, Symptoms, Risk Factors, Diagnosis, Treatment and Complications

Diagnosis Of Retrograde Ejaculation

To diagnose retrograde ejaculation, your doctor might:

  • Find out what kind of symptoms you are experiencing and how long they have lasted. Your doctor may ask about any previous surgeries, cancers, or other problems you may have had in addition to your medication schedule.
  • Examine yourself physically, including your rectum, testicles, and penis.
  • Check for semen in your urine after having an orgasm. This procedure is typically performed in the doctor's office. 
  • Your doctor is going to advise you to collect a urine sample and then provide a urine sample for laboratory analysis. Retrograde ejaculation happens when your urine contains a significant amount of sperm.
  • Your doctor may suspect a problem with semen production if, despite your dry orgasms, there is no semen in your bladder. Radiation therapy or surgery for pelvic cancer may cause damage to the prostate or semen-producing glands, which could result in this. If your doctor determines that the cause of your dry orgasm is not retrograde ejaculation, they may suggest further testing or a referral to a specialist.

Also Read: Testicular Torsion: Causes, Symptoms, Risk Factors, Diagnosis, Treatment, Prevention and Complications

Treatment Of Retrograde Ejaculation

Retrograde ejaculation normally doesn't require treatment unless it interferes with fertility. In these cases, the underlying cause dictates the course of treatment.


Medication may help with retrograde ejaculation caused by nerve injury. This type of damage can be caused by diabetes, multiple sclerosis, some surgical operations, and other diseases and treatments.

Medications typically won't be able to help if your retrograde ejaculation is the result of surgery that permanently changes your anatomy. Two examples include surgery on the bladder neck and prostate transurethral resection.

If your doctor believes a medicine is preventing you from ejaculating consistently, they may advise you to take it off for a period. 

Retrograde ejaculation can occur with some depression drugs and alpha blockers, which are taken for high blood pressure and some prostate diseases.

Prescriptions for retrograde ejaculation drugs are typically given to treat various illnesses, including:

  • Combining the blood vessel-constricting drug midodrine with the antidepressant imipramine
  • Chlorpheniramine and brompheniramine are examples of antihistamines that may reduce allergic symptoms.
  • Medicines that assist in curing common cold symptoms include phenylephrine, pseudoephedrine, and ephedrine.

These medications help to maintain the bladder neck muscle closed during ejaculation. Even though drugs are typically an effective treatment for retrograde ejaculation, they can also have side effects or negatively interact with other treatments. 

Some medications used to treat retrograde ejaculation might raise blood pressure and heart rate, which can be fatal if you have heart disease or high blood pressure.

Infertility Treatments

If you undergo retrograde ejaculation, you will likely need treatment to conceive with your female partner. For your spouse to become pregnant, you need to ejaculate enough semen into her uterus and vagina.

You and your partner will most likely need assisted reproductive technology, or IRT, to help you become pregnant if taking medication keeps you from ejaculating semen. It is occasionally feasible to extract sperm from the bladder, process them in a laboratory, and utilize the outcome to inseminate your partner (a procedure called intrauterine insemination).

More advanced techniques for assisted reproduction methods are occasionally required. A lot of males with retrograde ejaculation can get their partners pregnant once they seek treatment.

Also Read: Wound Healing, Tissue Repair & Scar

Prevention Of Retrograde Ejaculation

If you use medicine or have other health concerns, ask your doctor about ways to lower the risk of retrograde ejaculation.

If you need surgery (bladder, prostate, etc.) that could affect the muscles in your bladder and neck, ask about the possibility of retrograde ejaculation. 

Also Read: Cerebrovascular Disease (Meningocele, Arnold Chiari Malformation, Brain Herniation Syndrome)

Complications Of Retrograde Ejaculation

It is safe to ejaculate backward. However, possible problems include:

  • Male infertility, or the inability to conceive a woman
  • Less pleasurable orgasm due to fear of not ejaculating

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